Provider Demographics
NPI:1689830325
Name:CENTRAL VALLEY HOME HEALTH SERVICES, INC
Entity Type:Organization
Organization Name:CENTRAL VALLEY HOME HEALTH SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:A
Authorized Official - Last Name:EBERLE
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, RN, WCC
Authorized Official - Phone:209-526-8773
Mailing Address - Street 1:1216 H ST APT D
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95354-2431
Mailing Address - Country:US
Mailing Address - Phone:209-526-8773
Mailing Address - Fax:209-526-8774
Practice Address - Street 1:1216 H ST APT D
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95354-2431
Practice Address - Country:US
Practice Address - Phone:209-526-8773
Practice Address - Fax:209-526-8774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-01
Last Update Date:2010-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3125101251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health